Sociodemographic Variation in Early Uptake of COVID-19 Vaccine and Parental Intent and Attitudes Toward Vaccination of Children Aged 6 Months–4 Years — United States, July 1–29, 2022

Abstract

COVID-19 vaccines are safe and effective for infants and young children, and on June 18, 2022, CDC recommended COVID-19 vaccination for infants and children (children) aged 6 months-4 years (1,2). As of November 9, 2022, based on administrative data reported to CDC,* 5.9% of children aged <2 years and 8.8% of children aged 2-4 years had received ≥1 dose. To better understand reasons for low coverage among children aged <5 years, CDC analyzed data from 4,496 National Immunization Survey-Child COVID Module (NIS-CCM) interviews conducted during July 1-29, 2022, to examine variation in receipt of ≥1 dose of COVID-19 vaccine and parental intent to vaccinate children aged 6 months-4 years by sociodemographic characteristics and by parental beliefs about COVID-19; type of vaccination place was also reported. Among children aged 6 months-4 years, 3.5% were vaccinated; 59.3% were unvaccinated, but the parent was open to vaccination; and 37.2% were unvaccinated, and the parent was reluctant to vaccinate their child. Openness to vaccination was higher among parents of Hispanic or Latino (Hispanic) (66.2%), non-Hispanic Black or African American (Black) (61.1%), and non-Hispanic Asian (Asian) (83.1%) children than among parents of non-Hispanic White (White) (52.9%) children and lower among parents of children in rural areas (45.8%) than among parents of children in urban areas (64.1%). Parental confidence in COVID-19 vaccine safety and receipt of a provider recommendation for COVID-19 vaccination were lower among unvaccinated than vaccinated children. COVID-19 vaccine recommendations from a health care provider, along with dissemination of information about the safety of COVID-19 vaccine by trusted persons, could increase vaccination coverage among young children.NIS-CCM † is an ongoing, national random-digit-dialed mobile telephone survey of households that include children and adolescents aged 6 months-17 years (3,4). The survey respondent was a parent or guardian (parent) who indicated they were knowledgeable about the child's vaccination history. COVID-19 vaccination status was based on the parent's * Reported vaccination coverage estimates are by single year of age and, despite the vaccination recommendation targeting children aged 6 months to <5 years, population estimates for all children aged <5 years were used as the denominator. https://covid.cdc.gov/covid-data-tracker/#vaccination-demographic; https:// covid.cdc.gov/covid-data-tracker/#vaccination-demographics-trends

Factors Influencing Parent and Guardian Decisions on Vaccinating Their Children Against SARS-CoV-2: A Qualitative Study

“…Moreover, clear steps on how schools are planning to reduce COVID-19 risks, along with up-to-date safety and effectiveness data on vaccines, may help convince parents who do not want to vaccinate their children. 31,32 Finally, our analysis highlights the interesting role children have in the vaccination decision making process. While some parents/guardians made the choice to vaccinate their children, our results show that a number of parents/guardians considered their children's perspectives and supported their child's independent decisions.…”

“…Moreover, clear steps on how schools are planning to reduce COVID-19 risks, along with up-to-date safety and effectiveness data on vaccines, may help convince parents who do not want to vaccinate their children. 31 , 32 …”

Vaccines for Children Provider Practices in the COVID-19 Vaccination Program: Barriers to Participation, Intentions to Offer COVID-19 Vaccination to Children Aged <5 Years, and Vaccination Promotion, United States, March 2022

“…Among children aged 5 to 11 years who have received at least 1 dose of COVID-19 vaccine as of June 2022, 37% were vaccinated in a pharmacy, and 8% were vaccinated in a school-located vaccination clinic; fewer children aged <5 years with at least 1 dose have been vaccinated in either a pharmacy or school in the first month of vaccine availability (15.0% and 0.3%, respectively, as of July 2022). 11,12 Many pharmacies do not offer vaccine to children aged <5 years, and most that do offer vaccine only to those aged 3 years or older due to legal restrictions and other considerations. 13 Therefore, it is likely that young children will continue to be vaccinated in traditional medical settings such as doctor's office, underscoring the importance of the VFC provider network.…”

“…16 A recent report suggests that a lower proportion of parents of unvaccinated children aged <5 years had received a provider recommendation for COVID-19 vaccination than parents of vaccinated children. 12 Even if providers do not offer COVID-19 vaccine on site, their strong recommendation and willingness to engage in discussions with parents/caregivers to address parental questions and concerns is critical. Training and materials that are designed to help providers feel confident in discussing COVID-19 vaccination with parent/caregiver are readily available.…”

COVID-19 vaccination dynamics in the US: coverage velocity and carrying capacity based on socio-demographic vulnerability indices in California's pediatric population

“…By using the SVI, communities can better understand weaknesses and strengths in their communities so public health officials and emergency response planners can more efficiently allocate vital resources to their communities ( 25 ). The CDC and other peer-reviewed studies suggest that by utilizing the insights provided by the SVI to identify counties with low vaccination rates, state and local governments can prioritize their efforts and allocate funds toward regions that are most in need of the COVID-19 vaccine ( 15 , 17 – 19 ). Within these studies, some specific actions that can be taken to address inequities revealed by the SVI are community outreach programs, transmitting culturally relevant information to communities, teaming up with trusted messengers to provide accurate and timely information to communities, and ensuring accurate and timely supply of COVID-19 vaccines to communities ( 15 , 17 – 19 ).…”